Inositols in Polycystic Ovary Syndrome: A Comprehensive Review

Document Type : Review article

Authors

1 Aswan University

2 Obs & Gyn Department - Faculty of Medicine - Aswan University

3 Obs & Gyn department- Faculty of Medicine - Aswan University

Abstract

Polycystic ovary syndrome (PCOS) affects up to 13 % of women of reproductive age, yet no single therapy corrects its metabolic, reproductive, and psychological burden. This narrative review synthesizes studies on the two predominant inositol stereoisomers—myo-inositol (MI) and d-chiro-inositol (DCI). We outline inositol chemistry, endogenous distribution, and insulin-sensitizing mechanisms, then critically appraise evidence by preparation: MI 2–4 g/day, DCI 300–1,200 mg/day, and physiological 40:1 MI: DCI combinations. MI consistently lowers fasting insulin, HOMA-IR, and free testosterone, while restoring ovulation in up to two-thirds of participants; DCI shows similar metabolic gains but less robust reproductive data. Combined formulations accelerate improvements and may enhance in vitro fertilization outcomes. Across trials, adverse events are mild and gastrointestinal, with no serious safety signals. Ongoing multicenter randomized controlled trials (RCTs) targeting live-birth rate, long-term metabolic health, and pharmacogenomic predictors will clarify clinical positioning. Currently, inositols represent a safe, patient-preferred adjunct that can complement lifestyle change and first-line pharmacotherapy in selected PCOS phenotypes. Findings support personalized inositol use in routine practice.

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